Role of Laparoscopic-assisted Transversus Abdominis Plane Block during Elective Laparoscopic Cholecystectomy

Background: In today’s era of minimally invasive surgery, early postoperative pain reduction, early recovery, and return to normal activities are also important aspects. This study has been designed to analyze and compare the effect of laparoscopically administered transversus abdominis plane (TAP) block with port-site infiltration of long-acting local anesthetic agent (0.25 % bupivacaine) in cases of elective laparoscopic cholecystectomy. Materials and methods: This is a comparative study carried out at St Joseph Hospital, Ghaziabad, from September 2019 to March 2020 on 154 patients who underwent standard four-port laparoscopic cholecystectomy. Seventy-seven patients in group I received TAP block with 0.25 % bupivacaine and seventy-seven patients in group II received 20 mL of 0.25 % bupivacaine infiltration over port sites, including 10 mL each at epigastric and umbilical port and 5 mL each at midclavicular line and anterior axillary line ports, respectively. Various parameters were assessed during the intraoperative and postoperative periods. The pain was analyzed using visual analog scoring (VAS) for the first 24 hours at an interval of 3, 6, 12, and 24 hours. A note was made of any additional analgesic requirement. Results: Postoperative pain at 3, 6, and 12 hours was significantly reduced in group I who received TAP block as compared to those who received port-site infiltration. Hospital stay duration was significantly shorter in group I. Conclusion: Laparoscopic-assisted TAP block significantly reduces early postoperative pain, shortens hospital stay after elective laparoscopic cholecystectomy, and is a safe and cost-effective method without any extra requirement of specialized equipment and skills.